Welcome to the Medications Forum & Useful Sites!

[mrsD]

I didn't notice this was here until today.

Many medication questions should be directed to your doctor and pharmacist.
Pharmacies today provide extensive handouts to help you understand your
medications.

But given the way drugs are marketed today, some effects from newer
medications are not completely understood. So a forum of this type is a
good meeting place for people to exchange experiences about medications, when they are worried about them, or interactions.

A very good reference for drug information is:
www.rxlist.com

And this is a good reference for drug interactions:
http://health.discovery.com/encyclopedias/checker/checker.jsp

This one is very also:
http://www.pdrhealth.com/

If you have a problem with a medication toxicity or adverse reaction you can report it here:
http://www.fda.gov/
the medwatch program:
http://www.fda.gov/medwatch/index.html

If you have problems with understanding the medical terminology that you
find on the net, I can help members with that issue.

I also have experience about what really is going on compared to the dry,
medical stuff you can find on websites that give drug info. Some alarming things that you read about, don't commonly happen. And the vice versa,
some things you or your doctor don't expect, may happen to you.

I hope others come along here and offer web locations that they have found useful as well.

[mrsD]

Here is a good link to test drug interactions:

http://www.drugdigest.org/DD/Interaction/ChooseDrugs/1,4109,,00.html

And a very good paper on the effects of NSAIDs on the body, including
the new FDA warning about them:

http://arthritis.about.com/cs/nsaids/a/factsofnsaids.htm

And this database will match up drugs with complementary use of vitamins/minerals/herbs: Alot of interesting information can be found on this database.

http://www.umm.edu/altmed/

[mrsD]

As I come across them, I will post them here.
Unfortunately, many physicians do not read or understand some of the
new warnings that come out. Some never see them even. So I will post
links here in this post on those that are significant.
This is the main link from FDA:
http://www.fda.gov/cder/warn/warn2004.htm

This is a link to the search engine that you can use to search for your
specific drug, if you think a warning letter has been issued:
http://www.fda.gov/foi/warning.htm
There is some pretty interesting reading at the above site..if you choose
by date, you can see many issues the FDA oversees besides drugs.

1) Cymbalta:
http://www.medscape.com/viewarticle/514768

2) Topamax: There are several warnings included in this link:
http://www.fda.gov/cder/warn/2004/12547.pdf

3) Zoloft:
http://www.fda.gov/cder/warn/2005/zoloft_letter.pdf

4) Enbrel:
http://www.fda.gov/cder/warn/2005/Enbrelwl.pdf

5) Celebrex and Bextra:
http://www.fda.gov/cder/warn/2005/12560-letter.pdf
and http://www.fda.gov/medWatch/SAFETY/2005/safety05.htm#NSAID

6) Paxil + pregnancy:
http://www.fda.gov/MedWatch/SAFETY/2005/Paxil_dearhcp_letter.pdf
specifically the first trimester when the heart is forming. Discuss Paxil use with your doctor in this event.

These are just some examples. The site is huge.. and includes food and devices, and manufacturing issues/safety.

[agnuscrucis]

hey guys, :)

just for your information..
listen to Mrs. D, but it's good to be aware of what I have learned over the years..

better know something rather than not knowing anything. But the more you know seomthing, the more you know the things you don't know. that's why I stop asking (which is a very unwise thing to do, but I'm really tired.) in my experience the pharmacist only know so much.. OK, they know a lot, but in my case, absolutely not enough. I'm the one that have to do all the studying.. and now I'm so tired of studying. in the past weeks scary things have happened to me. It's time that I should start doing my homework to report to my doctors. But I don't even have enough energy to do what I utmostly need to do, so the homework just keep piling up, and dangerous things keep happening. Fortunately so far I still could manage. Believe it or not, my doctors trust me that I know what I'm doing.

And once I went to a American Epilepsy Society meeting, and I stopped by at different companies.. actually they got nervous that I asked questions.. (i could understand why). They all promised to send me the information, but at the end, only one company sent me something.. pretty much what's on ythe PDR. The thing is, once the drug is approved, the company wants nothing to do with studying it anymore. They only need one FDA approval and that's it, all they do after that is selling. long term effects? not their business.

not many people interested to study drug interactions. what for? first it's very expensive to do a proper study, second, they don't make any money out of this, and third, it's impossible to do a proper study anyway. All the studies that have been done have to use strict criterias. If you want a drug to be aprroved for diabetes, your studies will include only people with diabetes, not diabetes and stroke, or diabetes and MS etc. While in the real world, that is not the case. And also in the real world, people are taking so amny different variations of drugs, which are not the case with the people who are the subjects of these studies. And even furthermore, your genetic make ups (and your lifestyle etc.) determine how your body takes on the drug. And of course, a lot of people don't take the drug properly.. in other words, as labeled. :rolleyes:

[mrsD]

Here is a good site, listing the most commonly encountered drug-drug interactions:

http://www.aafp.org/afp/20000315/1745.html
It is dated 2000, so some newer things are not listed.
Such as SSRI bleeding risks. But the text is informative, and explanations are
good. Anyone taking multiple drugs should read it.

[mrsD]

In finding the truth among all the contention about the drug industry today,
there is a very good book written by an experienced M.D.:

The Truth About the Drug Companies by Marcia Angell M.D.
Here is part of a review of it:
In what should serve as the Fast Food Nation of the drug industry, Angell, former editor of the prestigious New England Journal of Medicine, presents a searing indictment of "big pharma" as corrupt and corrupting: of Congress, through huge campaign contributions; of the FDA, which is funded in part by the very companies it oversees; and, perhaps most shocking, of members of the medical profession and its institutions. Angell delineates how the drug giants, such as Pfizer and AstraZeneca, pay physicians to prescribe their products with gifts, junkets and marketing programs disguised as "professional education." According to Angell, the cost of marketing, both to physicians and consumers, far outweighs expenditures on research and development, though drug makers invoke R&D as the reason drug prices are so high. In fact, says Angell, with combined 2002 profits of $35.9 billion for the Fortune 500's top 10 drug companies, the drug industry is America's most profitable by far, thanks to disproportionately high prices, generous tax breaks and manipulation of patents to extend exclusive marketing rights to blockbuster drugs like Prozac and Claritin. Angell mounts a powerful case (and offers specific suggestions) for reform of this essential industry—a case worth bearing in mind as "big pharma" continues to oppose importing cheaper drugs from Canada.

Dr. Angell was editor of New England Journal of Medicine for 20 yrs.
Her experience and research are very revealing. One thing that surprised me is that the R & D departments of many major companies no longer do research.
They buy/lease patents from Universities and other research foundations who actually have the creative talent. Today drug companies mainly market.

While searching the net today, I also found this interesting doctoral thesis published on the Web. It echos Dr. Angell:
http://www.fdastudy.com/

And from the Wall Street Journal this echos the thesis above:
FDA Goes, Hat in Hand, To the Drug Industry
Topics: U.S. government | pharmaceuticals | health | corporations
Source: Wall Street Journal (sub req'd), September 1, 2006
Pills
"Regulators usually don't negotiate their budgets with the industries they oversee," writes Anna Wilde Mathews, but the U.S. Food and Drug Administration does. In the early 1990s, drug companies started paying the FDA millions of dollars in user fees, to speed the drug approval process. The fees "now fund more than half the agency's critical drug-review process." Industry groups and the FDA renegotiate the fees and how they're used every five years, giving drug makers "considerable input into which programs receive funding." The FDA is currently negotiating the next agreement, with the Pharmaceutical Research and Manufacturers of America and Biotechnology Industry Organization. The industry groups are pushing for faster decisions on "labels and other conditions on approval" of new drugs, and faster review of ads voluntarily submitted to the agency. The FDA wants more funding to monitor drugs' safety following their approval.

What is a person to do? Well, for starters if you have an adverse reaction to a drug --insist on a Medwatch report being made. Postmarketing has become the time when serious side effects appear. And if reports are not made, these effects damage many people. Right now in the news is the controversy over the antibiotic Ketek.

We are living at a time when patients should have a say, and research their own treatments. And this is just too difficult for many, sadly.



This book is a real eye opener and now is available in paperback. I bought my hardcover copy a while ago from Amazon.

[Chemar]

thanks for that excellent info mrsD!:)

It adds to the growing list of info and articles that I have on this disturbing subject, and reinforces the need for people to be diligent in researching things for themselves before simply accepting that just because something is FDA approved, that does not automatically mean it is safe or good for us! :Sigh:

ps note to everyone...please dont interpret my post as meaning i am "anti-drug" or saying that all drugs are unsafe....what I am saying is that we need to check out for ourselves what the potential side effects could be and make educated decisions. I know many people owe their lives to pharmaceuticals and so realise the vital importance of medications

[mrsD]

It is really critical to understand that care/and concern about drugs, to be
used properly and safely, is not to be interpreted as anti-drug.
I have been accused of this frequently, and it illustrates to me how emotional
the subject can be. Often doctors do not know much about how drugs work, and which ones are better than others. Today reliance is only on the drug salespeople, and this is very unfortunate.

I have been in this venue for 38 years now, and have seen many many changes.
It can be very alarming.

You know we need to be informed about many things. It is best to know something about cars, when obtaining service (esp if you are female), about
home repair, food safety, etc. We all can be affected by these complex
industries, negatively.

[ConsiderThis]

I have some bad memories related to being refused vitamins and forcefully administered FDA approved drugs.

I have some bad memories related to people taking control of me by saying I was a danger to myself when I wasn't.

In 1997 the bankruptcy court clerks couldn't find something I'd filed, and I said that if things that were supposed to protect me kept failing me that there was going to come a time when I'd kill myself... so the police were called; there were very wide hallways in the old bankruptcy court building in Albuquerque and they totally filled up with armed police. I was taken away to a mental hospital and in the course of events shot up with Haldol against my will. (My roommate was having electroshock therapy against her will, and to my surprise when I told the techs that she was not wanting a man who had come to visit touch her, they said, oh... she didn't speak much English and so it was hard for them to know what she was saying, but the man was her husband and he brought her in for shock therapy every so often... They told me, also, that she was catatonic without it... but she had helped me rearrange my bed and had smiled and communicated with me without words from the time she had been brought in.)

Later, when I read the hospital papers when I was going to try to sue, it said I had barricaded myself in at the IRS building... I wasn't even at the IRS building, much less had I barricaded myself in to anything.

(I was living in the home with hydrogen sulfide by the time I tried to sue, pro se, so there was little chance I could have succeeded, especially given that the judge would not allow me to read and I couldn't keep things straight when I tried to just say them.)

The mental hospital experience was extremely traumatic. It was after that that I first was unable to get my mind to work properly -- Gosh, I just feel like crying.

By "work properly" I'm not referring to memory alone, but to working memory, where you have more than one thing in mind at one time and then compare or contrast, etc.

So now it is extremely scary to me when someone "knows" what was best for me and makes it clear that if I don't agree then I am a danger to myself and can be forced to do as they think is best...

I think I feel so strongly because it was just horrible. They used to throw me to the floor, people I had trusted would surround me and throw me to the floor. (The man who I lived with was supposed to get a lawyer, but he was really a fraud and was looking for a way to get my property. He's in jail now because another woman was more clever than me and had evidence to have him prosecuted.)

I have felt scared a lot of the time ever since that experience.

Haldol is very scary because it can cause shaking for which there is no cure. But, it also as far as I can tell, does brain damage ... It might not do that if someone is not B12 deficient. I don't know. But I was B12 deficient. Only they said that if I had a level of 181, I think it was, that it was normal. They refused to give me a B12 shot or vitamin A which I used to control nasal drainage and without which I couldn't sleep. They said vitamin B12 and vitamin A were too dangerous.

But the Haldol... fine, despite the fact that it sometimes causes "unexplained" death. Haldol is, of course, FDA approved.

I find the established beliefs of people who profit and don't really care about the effects to be devastating.

Therefore, I think it is important that people pay attention to their own health, keep notes on what symptoms they have and how those symptoms are affected by things they take... then, do more for themselves of the things that help them.

[mrsD]

To the new OTC warnings about OTC pain relievers:

http://psychcentral.com/news/2006/12/20/fda-to-improve-warnings-on-otc-pain-meds/

For Products Containing Acetaminophen

• To require new warnings which would highlight the potential for liver toxicity, particularly when using acetaminophen in high doses, when taking more than one product with acetaminophen, and when taken with moderate amounts of alcohol;
• To require that the ingredient acetaminophen be prominently identified on the product’s principal display panel (PDP) of the immediate container, and the outer carton (if applicable).
For Products Containing NSAIDs
• To require new warnings for products that contain an NSAID which would highlight the potential for stomach bleeding in persons over age 60, in persons who have had prior ulcers or bleeding, in persons who take a blood thinner, when taking more than one product containing an NSAID, when taken with moderate amounts of alcohol, and when taking for longer time than directed; and
• To require that the name of the NSAID ingredient and the term “NSAID” be prominently identified on the product’s PDP of the immediate container and the outer carton (if applicable).

[mrsD]

The FDA in USA is strengthening warnings for both of these anemia drugs.

http://www.washingtonpost.com/wp-dyn/content/article/2007/03/11/AR2007031100339.html

Increased potential for death is being reported with them.

They are also used in doping during the winter olympics increasingly.

[Chemar]

http://www.fda.gov/bbs/topics/NEWS/2007/NEW01587.html

FDA Requests Label Change for All Sleep Disorder Drug Products

The U.S. Food and Drug Administration (FDA) has requested that all manufacturers of sedative-hypnotic drug products, a class of drugs used to induce and/or maintain sleep, strengthen their product labeling to include stronger language concerning potential risks. These risks include severe allergic reactions and complex sleep-related behaviors, which may include sleep-driving. Sleep driving is defined as driving while not fully awake after ingestion of a sedative-hypnotic product, with no memory of the event................................

[mrsD]

Here is an FDA report on the discontinuance of Zelnorm:

FDA: Zelnorm Being Pulled From Market

ROCKVILLE, MD -- March 30, 2007 -- FDA is issuing this public health advisory to inform patients and health care professionals that the sponsor of Zelnorm (tegaserod maleate), Novartis Pharmaceuticals Corporation, has agreed to stop selling Zelnorm. Zelnorm is being taken off the market because a new safety analysis has found a higher chance of heart attack, stroke, and worsening heart chest pain that can become a heart attack in patients treated with Zelnorm compared to those treated with a sugar pill they thought was Zelnorm.

FDA announces the following, effective immediately:

· At FDA's request, Novartis Pharmaceuticals Corporation has agreed to stop selling Zelnorm.
· Patients being treated with Zelnorm should contact their physician to discuss alternative treatments for their condition.
· Patients who are taking Zelnorm should seek emergency medical care right away if they experience severe chest pain, shortness of breath, dizziness, sudden onset of weakness or difficulty walking or talking or other symptoms of a heart attack or stroke.
· Physicians who prescribe Zelnorm should work with their patients and transition them to other therapies as appropriate to their symptoms and need.

Zelnorm is a prescription medication approved for short term treatment of women with irritable bowel syndrome with constipation and for patients younger than 65 years with chronic constipation. In late February and early March 2007, Novartis Pharmaceuticals gave FDA the results of new analyses of 29 clinical studies of Zelnorm for treatment of a variety of gastrointestinal tract conditions; the data from all the studies were combined to assess the chance of side effects on the heart and blood vessels. In each study, patients were assigned at random to either Zelnorm or a sugar pill they thought was Zelnorm. These 29 studies included 11,614 patients treated with Zelnorm and 7,031 treated with a sugar pill. The average age of patients in these studies was 43 years and most patients -- 88% -- were women.

The number of patients who suffered a heart attack, stroke or severe heart chest pain that can turn into a heart attack was small. However, patients treated with Zelnorm had a higher chance of having any of these serious and life-threatening side effects than did those who were treated with a sugar pill. Thirteen patients treated with Zelnorm (0.1%) had serious and life-threatening cardiovascular side effects; among these, four patients had a heart attack (one died), six had a type of severe heart chest pain which can quickly turn into a heart attack, and three had a stroke. Among the patients taking the sugar pill, only one (or 0.01%) had symptoms suggesting the beginning of a stroke that went away without complication.

There may be patients for whom no other treatment options are available and in whom the benefits of Zelnorm treatment outweigh the chance of serious side effects. FDA will work with Novartis to allow access to Zelnorm for those patients through a special program.

FDA has also indicated to Novartis a willingness to consider limited re-introduction of Zelnorm at a later date if a population of patients can be identified in whom the benefits of the drug outweigh the risks. However, before FDA makes a decision about limited re-introduction, any proposed plan would be discussed at a public advisory committee meeting.


SOURCE: FDA

This is how Zelnorm works... and its affects on serotonin seem to be what is
causing the cardiovascular incidents:
Tegaserod is a 5-HT4 receptor partial agonist that binds with high affinity at human 5-HT4 receptors, whereas it has no appreciable affinity for 5-HT3 or dopamine receptors. It has moderate affinity for 5-HT1 receptors. Tegaserod, by acting as an agonist at neuronal 5-HT4 receptors, triggers the release of further neurotransmitters such as calcitonin gene-related peptide from sensory neurons. The activation of 5-HT4 receptors in the gastrointestinal tract stimulates the peristaltic reflex and intestinal secretion, as well as inhibits visceral sensitivity. In vivo studies showed that tegaserod enhanced basal motor activity and normalized impaired motility throughout the gastrointestinal tract. In addition, studies demonstrated that tegaserod moderated visceral sensitivity during colorectal distension in animals.

Zelnorm was used for irritable bowel syndrome, for selected patients with chronic constipation, and for those who use chronic opioid therapy for pain (which results in constipation).

[mrsD]

This is a good reference for identifying drugs:

http://www.pharmer.org/identification

[mmmstly]

Mrs. D.:

Thank you for this information. I am one of those women whose whole life has been micromanaged by IBS.

I was literally loosing what life I had until Zelnorm.

And, it's not that I have a life now. However, w/Zelnorm I was/am on the road to living a normal life...

In your piece you said, "There may be patients for whom no other treatment options are available and in whom the benefits of Zelnorm treatment outweigh the chance of serious side effects. FDA will work with Novartis to allow access to Zelnorm for those patients through a special program."

How do I do this?

I am fearful that I may even loose my ability to earn a living without this product.

And, really, what life do I have if I can't work, go outside my home, develop & participate in life and relationships because of major symptoms of IBS?

My IBS is crippling. I am still on FMLA from its debilitating effects—

Thanks for any support, information or suggestions,

mmmstly

[Jo*mar]

Some of these might have been posted already..

Medication & Drug Interaction checkers


http://www.drugs.com/drug_interactions.html

http://www.drugdigest.org

http://www.healthsquare.com/drugmain.htm

http://www.drugs.com/

http://gsm.about.com/interact/inter.asp

http://www.healthatoz.com/healthatoz/Atoz/drugdb/drugGuideHome.jsp

http://www.askapatient.com/

[mrsD]

Here is a very interesting site. It details FDA medwatch reports.

http://www.patientsville.com/sitemap.htm

Keep in mind that some people's reactions may be due to other disease processes going on with them. Also the opposite factor should be considered, that many drug reactions go UNREPORTED.

So don't panic, but do be concerned and careful.

[mrsD]

http://ncpa.yellowbrix.com/pages/ncpa/Story.nsp?story_id=111440559&ID=ncpa

FDA Revises Cialis, Levitra, Viagra Labels
Source: United Press International
Publication date: 2007-10-22

The U.S. Food and Drug Administration has revised the labeling of the erectile dysfunction drugs Cialis, Levitra and Viagra to warn of possible hearing loss.

The FDA said the labels now will offer inform people of the potential risk of sudden hearing loss, and guide them on what to do if they experience sudden problems with their hearing.

In addition, the FDA said it plans to require the same changes in labeling for the drug Revatio, which is used to treat pulmonary arterial hypertension -- a serious medical condition in which continuous high blood pressure in arteries of the lungs weakens the heart muscle and often leads to right heart failure and death.

The FDA said it asked manufacturers to revise product labeling after a very small number of patients reported sudden hearing loss, sometimes accompanied by ringing in the ears and dizziness.

Patients taking Cialis, Levitra or Viagra who experience sudden hearing loss should immediately stop taking the drug and seek prompt medical attention. Those using Revatio should continue taking their medication, but should contact their health care provider for further evaluation.

More details here:
http://www.fda.gov/bbs/topics/NEWS/2007/NEW01730.html

[mrsD]

Each year more and more is learned about drugs interfering with each other, by either inducing metabolism or inhibiting it.

The subject of pomegranate juice just came up on Bipolar board, so I thought
I'd put up some charts that I found that people can consult. Doctors don't always know this information, or understand it.

http://www.healthanddna.com/drugchart.html

This link explains the effects of various juices at this time:
http://www.netwellness.org/question.cfm/44966.htm

and this link has just info about grapefruit:
http://www.fhma.com/grapefruit.htm

Lists are subject to change, as data changes. So keep that in mind.

[Jo*mar]

Scroll down the page for the many links listed.
http://www.spacedoc.net/

[mrsD]

I have started a thread on our Vitamin forum here for questions people may have on this subject.

Resources are posted there, so I won't repeat them here.

Some side effects from long term use of common medications affect our
body's ability to use certain nutrients. Vit D, calcium, zinc, magnesium, potassium B-complex are just some that are robbed from our bodies.

I have 2 textbook links and one web link posted here:
http://neurotalk.psychcentral.com/thread42135.html

[mrsD]

Here is a conversion site to help show relative conversion between
opiate drugs.

http://www.globalrph.com/narcoticonv.htm

Not everyone reacts the same way, however, so this is just an approximation.